目的 探讨脑电生物反馈（neurofeedback, NFB）联合学习风格简介（learning style profile, LSP）干预训练在高功能孤独症谱系障碍（high-functioning autism, HFA）患儿中的应用。 方法 前瞻性选择2022年2月—2024年2月收治的86例HFA患儿为研究对象，采用随机数字表法分为对照组和观察组，行双盲试验，每组各43例。对照组给予LSP干预训练，观察组在对照组基础上给予NFB干预，两组均干预6个月。比较两组患儿干预前、干预6个月时孤独症行为评定量表（Autism Behavior Checklist, ABC）、孤独症疗效评定量表（Autism Treatment Evaluation Checklist, ATEC）、社交反应量表（Social Responsiveness Scale, SRS）、儿童生存质量量表（Pediatric Quality of Life, PedsQL）评分差异；分析HFA患儿PedsQL评分与ABC、ATEC、SRS评分的相关性。 结果 干预6个月后，观察组ABC、ATEC、SRS评分低于对照组，PedsQL评分高于对照组（P<0.05）；HFA患儿PedsQL评分与ABC、ATEC、SRS评分呈负相关（分别r=-0.238、-0.381、-0.219，P<0.001）。 结论 NFB联合LSP能够有效改善HFA患儿临床症状及社交能力，控制患儿病情发展，提升患儿生活质量。
Abstract
Objective To explore the application of neurofeedback (NFB) combined with learning style profile (LSP) intervention training in children with high-functioning autism (HFA). Methods A prospective study was conducted to select 86 children with HFA admitted to the hospital from February 2022 to February 2024. They were divided into two groups according to the random number table method, with 43 cases in each group. In this double-blind study, the control group was given LSP intervention training, and the observation group was given NFB intervention on the basis of the treatment used in the control group. Both groups were treated for 6 months. The scores of Autism Behavior Checklist (ABC), Autism Treatment Evaluation Checklist (ATEC), Social Responsiveness Scale (SRS), and Pediatric Quality of Life (PedsQL) were compared between the two groups before intervention and at 6 months after intervention. The relationship of PedsQL score with ABC, ATEC, and SRS scores was analyzed in children with HFA. Results After 6 months of intervention, the scores of ABC, ATEC, and SRS in the observation group were significantly lower than those in the control group, while the PedsQL score in the observation group was significantly higher than that in the control group (P<0.05). The PedsQL score was negatively correlated with the ABC, ATEC, and SRS scores in children with HFA (r=-0.238, -0.381, -0.219 respectively; P<0.001). Conclusions NFB combined with LSP can effectively improve the clinical symptoms and social ability, control the development of the disease, and improve the quality of life in children with HFA.
关键词
高功能孤独症谱系障碍 /
脑电生物反馈 /
学习风格简介 /
临床症状 /
生活质量 /
社交 /
儿童
Key words
High-functioning autism /
Neurofeedback /
Learning style profile /
Clinical symptom /
Quality of life /
Social ability /
Child
{{custom_sec.title}}
{{custom_sec.title}}
{{custom_sec.content}}
参考文献
1 Wang L, Wang B, Wu C, et al. Autism spectrum disorder: neurodevelopmental risk factors, biological mechanism, and precision therapy[J]. Int J Mol Sci, 2023, 24(3): 1819. PMID: 36768153. PMCID: PMC9915249. DOI: 10.3390/ijms24031819.
2 陈倩, 王馨, 曹牧青, 等. 高功能孤独症谱系障碍患儿基本表情识别的眼动特征及其与社交损伤的关联[J]. 中华儿科杂志, 2021, 59(6): 484-488. PMID: 34102822. DOI: 10.3760/cma.j.cn112140-20210106-00014.
3 马晨欢, 王莎莎, 李孟凡, 等. 学习风格简介干预模式对孤独症谱系障碍患儿康复效果的评估[J]. 中国儿童保健杂志, 2020, 28(4): 482-485. DOI: 10.11852/zgetbjzz2019-0890.
4 Quinn MM, Smith T, Kalmar EL, et al. What type of learner are your students? Preferred learning styles of undergraduate gross anatomy students according to the index of learning styles questionnaire[J]. Anat Sci Educ, 2018, 11(4): 358-365. PMID: 29096042. DOI: 10.1002/ase.1748.
5 Matsuzaki J, Kagitani-Shimono K, Aoki S, et al. Abnormal cortical responses elicited by audiovisual movies in patients with autism spectrum disorder with atypical sensory behavior: a magnetoencephalographic study[J]. Brain Dev, 2022, 44(2): 81-94. PMID: 34563417. DOI: 10.1016/j.braindev.2021.08.007.
6 Moreno-García I, Cano-Crespo A, Rivera F. Results of neurofeedback in treatment of children with ADHD: a systematic review of randomized controlled trials[J]. Appl Psychophysiol Biofeedback, 2022, 47(3): 145-181. PMID: 35612676. DOI: 10.1007/s10484-022-09547-1.
7 卫群郦, 孔庆芳, 王雯蕾. 强化无错性节奏训练联合脑电生物反馈对精神分裂症患者认知功能及信息处理速度的影响[J]. 国际精神病学杂志, 2023, 50(3): 427-429. DOI: 10.13479/j.cnki.jip.2023.03.050.
8 Direito B, Mouga S, Sayal A, et al. Training the social brain: clinical and neural effects of an 8-week real-time functional magnetic resonance imaging neurofeedback phase IIa clinical trial in autism[J]. Autism, 2021, 25(6): 1746-1760. PMID: 33765841. DOI: 10.1177/13623613211002052.
9 Sun PP, Teng LS. Profiling perceptual learning styles of Chinese as a second language learners in university settings[J]. J Psycholinguist Res, 2017, 46(6): 1529-1548. PMID: 28639174. DOI: 10.1007/s10936-017-9506-y.
10 Battle DE. Diagnostic and statistical manual of mental disorders (DSM)[J]. Codas, 2013, 25(2): 191-192. PMID: 24413388. DOI: 10.1590/s2317-17822013000200017.
11 Haem E, Doostfatemeh M, Firouzabadi N, et al. A longitudinal item response model for aberrant behavior checklist (ABC) data from children with autism[J]. J Pharmacokinet Pharmacodyn, 2020, 47(3): 241-253. PMID: 32285302 DOI: 10.1007/s10928-020-09686-0.
12 卢建平, 杨志伟, 舒明耀, 等. 儿童孤独症量表评定的信度、效度分析[J]. 中国现代医学杂志, 2004, 14(13): 119-121. DOI: 10.3969/j.issn.1005-8982.2004.13.037.
13 Kovacs Balint Z, Raper J, Michopoulos V, et al. Validation of the Social Responsiveness Scale (SRS) to screen for atypical social behaviors in juvenile macaques[J]. PLoS One, 2021, 16(5): e0235946. PMID: 34014933. PMCID: PMC8136728. DOI: 10.1371/journal.pone.0235946.
14 Lemmon ME, Huffstetler HE, Reeve BB. Measuring health-related quality of life in pediatric neurology[J]. J Child Neurol, 2020, 35(10): 681-689. PMID: 32498657. PMCID: PMC7415579. DOI: 10.1177/0883073820923809.
15 Genovese A, Butler MG. Clinical assessment, genetics, and treatment approaches in autism spectrum disorder (ASD)[J]. Int J Mol Sci, 2020, 21(13): 4726. PMID: 32630718. PMCID: PMC7369758. DOI: 10.3390/ijms21134726.
16 Mirzaei SS, Pakdaman S, Alizadeh E, et al. A systematic review of program circumstances in training social skills to adolescents with high-functioning autism[J]. Int J Dev Disabil, 2022, 68(3): 237-246. PMID: 35603001. PMCID: PMC9122374. DOI: 10.1080/20473869.2020.1748802.
17 Mihailescu I, Andrei LE, Frunza AA, et al. Computer-based assessment and self-report measures of executive functions in high-functioning adults with autism[J]. Brain Sci, 2022, 12(8): 1069. PMID: 36009132. PMCID: PMC9405696. DOI: 10.3390/brainsci12081069.
18 Ceranoglu TA, Cassano P, Hoskova B, et al. Transcranial photobiomodulation in adults with high-functioning autism spectrum disorder: positive findings from a proof-of-concept study[J]. Photobiomodul Photomed Laser Surg, 2022, 40(1): 4-12. PMID: 34941429. DOI: 10.1089/photob.2020.4986.
19 Ma CH, Chen LY, Li MF, et al. Treatment of preschool children with autism spectrum disorder: a trial to evaluate a learning style profile intervention program in China[J]. Front Pediatr, 2022, 10: 831621. PMID: 35372141. PMCID: PMC8966376. DOI: 10.3389/fped.2022.831621.
20 马晨欢, 陈凌燕, 李孟凡, 等. 学习风格简介干预训练的自闭症儿童康复疗效的影响因素分析[J]. 中国妇幼保健, 2022, 37(23): 4464-4468. DOI: 10.19829/j.zgfybj.issn.1001-4411.2022.23.035.
21 Varela Barrenechea F. Efficacy of neurofeedback as a treatment for people with subjective tinnitus in reducing the symptom and related consequences: a systematic review from 2010 to 2020[J]. Acta Otorrinolaringol Esp (Engl Ed), 2023, 74(4): 253-262. PMID: 36257576. DOI: 10.1016/j.otoeng.2022.10.003.
22 Rosello R, Martinez-Raga J, Tomas JM, et al. Cognitive and behavioral profiles in children with autism spectrum disorder with and without attention-deficit/hyperactivity disorder[J]. Child Adolesc Ment Health, 2023, 28(2): 269-276. PMID: 35441444. DOI: 10.1111/camh.12562.
23 Hamed R, Mizrachi L, Granovsky Y, et al. Neurofeedback therapy for sensory over-responsiveness: a feasibility study[J]. Sensors (Basel), 2022, 22(5): 1845. PMID: 35270991. PMCID: PMC8914621. DOI: 10.3390/s22051845.
24 Werneck-Rohrer SG, Lindorfer TM, Waleew C, et al. Effects of an intensive slow cortical potentials neurofeedback training in female and male adolescents with autism spectrum disorder: are there sex differences?[J]. Wien Klin Wochenschr, 2022, 134(Suppl 1): 60-68. PMID: 34910250. PMCID: PMC8671879. DOI: 10.1007/s00508-021-01989-7.
25 Kl?bl M, Prillinger K, Diehm R, et al. Individual brain regulation as learned via neurofeedback is related to affective changes in adolescents with autism spectrum disorder[J]. Child Adolesc Psychiatry Ment Health, 2023, 17(1): 6. PMID: 36635760. PMCID: PMC9837918. DOI: 10.1186/s13034-022-00549-9.
26 李梦青, 姜志梅, 李雪梅, 等. rTMS结合脑电生物反馈对孤独症谱系障碍儿童刻板行为的疗效[J]. 中国康复, 2018, 33(2): 114-117. DOI: 10.3870/zgkf.2018.02.007.
27 Mahapatra S, Khokhlovich E, Martinez S, et al. Longitudinal epidemiological study of autism subgroups using Autism Treatment Evaluation Checklist (ATEC) Score[J]. J Autism Dev Disord, 2020, 50(5): 1497-1508. PMID: 30062397. PMCID: PMC7211200. DOI: 10.1007/s10803-018-3699-2.
PDF(537 KB)
